Saturday, June 12, 2010

Balance, Walking and Falling Problems Can be an Early Sign of Alzheimer's Dementia

Balance and walking problems often present before the diagnosis of mild cognitive impairment, Alzheimer's or dementia...

By Bob DeMarcoAlzheimer's Reading Room

When I first came to Delray Beach to take care of my mother, she was falling down all the time. Once, I found her laying in the parking lot and she could not get up. She was shaking like a leaf. Another time she fell down and broke her little finger. It took us over ten hours in the emergency room that time around. She would fall and couldn't get back up.

This might sound hard to believe, she has not fallen once in the last six years. I attribute this mostly to exercise on a treadmill, the loss of about 17 pounds, and initially to Aricept.

Now, my mother can barely walk without holding on to my hand, or grabbing whatever she can find to hold on to as she walks (like a chair or the wall). I am still grateful, and amazed, that she is not falling. My mother is not yet using a walker (which is another story in itself).

Perhaps some of you can describe your own experiences with walking, balance and falling.

I would suggest as soon as you see problems with walking, falling, or shuffling feet in an elderly person that you get their memory tested immediately.

Poor balance may indicate memory decline

A simple balance test may help doctors predict a decline in memory and brain function in people with Alzheimer's disease, research shows.

In a study, researchers found that Alzheimer's patients with an abnormal one-leg balance test experienced greater decline in brain function over two years than those with a normal one-leg balance test.

"Our results reinforce, in an Alzheimer's disease population, the growing evidence suggesting a link between physical performances and cognitive decline," study chief Dr. Yves Rolland, of the University of Toulouse III, France, noted in a written statement. "If these results are confirmed by other data, the one-leg balance test could be adopted in clinical practice to identify Alzheimer's disease patients at high risk of rapid cognitive decline," the researcher added.

According to a report of the study published in the Journal of Alzheimer's Disease, 686 patients with Alzheimer's disease were evaluated by a geriatrician every six months for up to two years, and their degree of cognitive impairment was measured. At the same time, a "one-leg balance" test was given, where a participant was asked to stand on one leg for as long as possible.

The test was considered abnormal when the participant was unable to stand on one leg for 5 seconds or more. At the outset, roughly 15 percent of the study subjects had an abnormal one-leg balance test and these patients were significantly older and had significantly more severe cognitive impairment.

In analyses taking into account factors that might influence the results, the researchers found that subjects with an abnormal one-leg balance test had significantly greater decline in memory and thinking at 12, 18 and 24 months.

For example, the average decline on the Mini-Mental State Examination at 24 months was 9.2 points when balance impairment was present, compared with just 3.8 points with no balance impairment. "The one-leg balance test is a stress test that may characterize subjects with low cognitive reserve," Rolland and colleagues conclude.